Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit

ABSTRACT

Objective

The objectives of this study were to identify maternal psychological responses to infants’ neonatal intensive care unit (NICU) admission, understand the relationship between psychological symptoms and maternal-infant attachment, and evaluate change in psychological symptoms over time.

Background

Accumulating evidence suggests that infants’ admission to a NICU may adversely impact maternal psychiatric functioning. NICU mothers typically experience high levels of depressive, anxiety, and stress symptoms.

Methods

Mothers (N = 127) recruited from their infants’ NICU bedside at three hospitals in the Philadelphia area completed self-report measures of depression, anxiety, stress, and maternal-infant attachment during the NICU admission and then 2–4 months later. A series of bivariate correlations, paired samples t-tests, and linear regression analyses were used to evaluate the primary study aims.

Results

NICU mothers reported elevated rates of depressive, anxiety, and stress symptoms. Maternal-infant attachment was negatively associated with anxiety and stress symptoms. Both depressive and anxiety symptoms were higher during NICU admission compared to 2–4 months later, and depressive symptoms during NICU admission predicted depressive symptoms 2–4 months later.

Conclusions

This study demonstrates that NICU admission may heighten maternal risk for psychiatric symptoms, and maternal-infant attachment in the NICU may be an important correlate of maternal anxiety and stress symptoms.

KEYWORDS:

• Neonatal intensive care unit
• maternal-infant attachment
• postpartum depression
• postpartum anxiety

Acknowledgments

The authors wish to thank the NICU mothers who participated in this research project. The authors also wish to acknowledge Victoria Grunberg, MS and Lauren DeRuyter, MMS for their assistance with the data collection procedures and project management.

Disclosure statement

No potential conflict of interest was reported by the authors.